Is Less Ablation Better for AFib?

While hybrid ablation continues to evolve, some researchers are questioning the idea of more being better in treating persistent atrial fibrillation (AFib).

A 2015 trial followed 589 patients who had persistent atrial fibrillation for less than three years. They all underwent catheter ablation—either limited to the tissue around the pulmonary veins (which is standard), or targeting a wider area of tissue.

After 18 months, patients who had undergone more extensive ablation were no more likely to be symptom-free after a single procedure: just under half were, versus 59 percent of patients who had standard ablation. With no clear benefit from burning extra tissue, the potential risks from the longer procedure—including sedation-related problems and injury to the heart—may not be worth it.